Cancer survivor and novelist, Lia Mills, never imagined that her desire to lose weight would come true in such a horrific way, says Sue Leonard

In March 2006 Lia Mills attended a celebration dinner. Her second novel, Nothing Simple, was on the shortlist for the inaugural Irish Books Awards. She didn't win, that honour went to John Banville, but, with a third novel half written, life was good.

In March 2006 Lia Mills attended a celebration dinner. Her second novel, Nothing Simple, was on the shortlist for the inaugural Irish Books Awards. She didn't win, that honour went to John Banville, but, with a third novel half written, life was good.

Just one thing bothered the 48-year-old. A habitually thin person, she resented the extra weight that middle age had wrought on her figure.

"I could not fit into the clothes I wanted to wear. I'd look into the mirror and think, 'who is that person?'"

Lia longed to lose a stone or two.

"Be careful what you wish for," she says, wryly. Because Lia has, indeed, lost her goal weight, and more. But that's because she spent five months fighting a most vicious form of cancer; that she survived at all is something of a miracle.

It began with a wisdom tooth, Lia had one removed in 2005. Months later, though, her cheek became sore again, and developed whitish patches. Her dentist gave her a gel for her "mouth ulcer". And it wasn't until April the following year that a tumour in her cheek was diagnosed.

In May, Lia underwent a massive 14 hours of surgery. The tumour was removed, along with a large section of jaw and several teeth. To reconstruct her jaw, a good deal of bone was hacked from her leg. She was left temporarily speechless, with a tracheotomy tube in place, and had to be fed by tube for the following few weeks. It was weeks before doctors discovered that the leg they'd urged her to exercise was actually broken.

Radiotherapy produced unbelievable hell, with constant vomiting and diarrhoea. But, by November the worst was over. Today, she is willowy, with thick brown curls. There's an indent in one cheek but, miraculously, when facial nerves were severed, Lia has retained her smile. She talks well too. And she appreciates all of that, so very much.

By the time her diagnosis came, though, the tumour had grown to huge proportions. Were it not for her persistent GP, she would have died. Doesn't that make her angry? "At first I did want to find someone to blame," she says. "But I realised there was no point in looking back, in thinking 'what if'. That wasn't going to change a thing. I needed all my energy to move forward.

"And beside, I was the one who had let it go on for as long as it had. I just didn't believe that it could be cancer. I thought, 'if you make a big fuss and it ends up being nothing you are going to feel stupid'."

All through those months of hell, Lia kept a diary. Endlessly scribbling in notebooks, she recounted her treatment, her emotions, and made a note of everything that was going on around her.

Uplifting

And though the resulting book, In Your Face, is a harrowing read, the quality of the writing and Lia's attitude to her illness makes it, ultimately, an uplifting story of survival.

Lia's appreciation of nature, the strength of her friendships, her humour, and her sense of the suspension of her life are beautifully conveyed.

She thought of the tumour as her enemy. "My face is eating me," she wrote. "I really did feel that I was fighting something tangible," she says now. "This thing was there, taking root. The tumour was at a stage where you could literally see it getting bigger. I was aware of it all the time.

"It's like with toothache, it hurts and you can't think about anything else." In general, she found the medical staff that treated her to be fantastic, but there were some surreal moments, particularly the day Lia got her diagnosis. The doctor, the results in his hand, seemed reluctant to pass on the news. He rang around, in vain, for a consultant. In the end Lia read the diagnosis herself; it was squamous cell carcinoma.

"That was so surreal," she says. "I could not believe it was happening. My sister Jackie and I just looked at each other; I was in deep shock, but in denial. So in some weird way it was turning into a funny story. "

On the eve of her operation, Lia was advised, in front of her three daughters, to arrange her will. "All our instincts were to protect each other," she says. "We all looked at Vanessa, who at 19 was the youngest. "My children were all brilliant," she says. " Vanessa offered not to take a summer job, not to go away. She gave up her summer looking after me. "Emma was coming up to her finals in University College Dublin. Her job was to do as well as she possibly could. And she did, gaining a first and winning a prize. That meant so much.

"And my eldest, Zita, stayed with me with her partner and son for a few days every week. Life went on, and they were all there to help prop me up. It was amazing."

Now in her second year of recovery, Lia's check-ups have been reduced from every month to every two months.

By five years she will be considered cured.

With death no longer an imminent fear, life has become ordinary again. " I now worry about the traffic, and about my bank balance as much as everyone else does," she says.

"But I still wake up, every day, with that sense of the beauty of the day. The biggest surprise of my illness was discovering how badly I wanted to live. I was depressed as a teenager and I had post-natal depression after my first daughter, so I know what despair feels like.

"I had always thought 'I will get to do that and that', and suddenly I realised I might not have the time. I realised 'this isn't a first draft, it's for real'."

Oral cancer: the facts

The instance of oral cancer among women has increased from 12% to 33% of cases since the 1990s. This trend seems set to continue.

Oral cancer in women is as common as cervical cancer.

Early diagnosis is vital. Caught early, there is an 86% chance of survival. This drops to just 10% for advanced oral cancer.

If you notice a prolonged lump, mouth ulcer or white patch, go to your dentist or doctor immediately.